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PHARMACOLOGY I > corticosteroids > Flashcards

corticosteroids Flashcards

(51 cards)

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1
Q

what stimulates the zona glomerulosa to produce Aldosterone

A

Angiotensin II & K+

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2
Q

what stimulates the zona fasciculata & what does it produce

A

ACTH
cortisol

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3
Q

what does the zona reticularis produce

A

Adrenal androgens

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4
Q

what are cortisol & aldosterone released from

A

Adrenal cortex

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5
Q

what stimulates the release of Cortisol & aldosterone from the adrenal cortex

A

ACTH

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6
Q

what does aldosterone do

A

increases Na and H20 retention
increases K+ excretion

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7
Q

Glucocorticoids are anti- ?

A

inflammatory

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8
Q

how do glucocorticoids counter the effect of insulin

A
  • increase circulating amino acids
  • increase circulating fatty acids
  • increases gluconeogenesis
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9
Q

what is the effect of glucocorticoids on thyroid hormones

A

decreases TSH and therefore decreases thyroid hormone

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10
Q

what is the affect of glucocorticoids on ACTH

A

decreases ACTH via negative feedback on CRH

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11
Q

what is the number one cause of hypoadrenocorticism (Addison’s)

A

autoimmune disorder

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12
Q

what are the causes of hypoadrenocorticism

A
  • Primary autoimmune disorder (90%)
  • iatrogenic
  • neoplastic (pituitary tumor destroys ACTH production)
  • breed predisposition
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13
Q

gradual process that presents acutely - signs become apparent with 90% loss of adrenal cortex

A

hypoadrenocorticism
signs are vague: poor BCS, weight loss, lethargy

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14
Q

severe signs of hypoadrenocorticism

A
  • Bradycardia
  • hypovolemic shock
  • anemia
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15
Q

how do Na, K, Cl levels present in a hypoadrenocorticism patient

A
  • hyperkalemia
  • hyponatremia
  • hypochloremia
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16
Q

glucocorticoid absorbed poorly in feline and equines

A

prednisone

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17
Q

glucocorticoids are _____ soluble & therefore are distributed widely

A

lipid

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18
Q

glucocorticoids are bound in plasma by ______ & ________

A

albumin and corticosteroid binding globulin

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19
Q

prednisone & cortisone are both ?

A

prodrugs
prednisone –> prednisolone
cortisone –> hydrocortisone

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20
Q

prednisone and cortisone are bad choices for what patients and why

A

prednisone - cats b/c can’t metabolize
animals in liver failure won’t metabolize either drug

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21
Q

how are glucocorticoids useful in the treatment of osteoarthritis

Study These Flashcards
A

they reduce production of PGE2 by synoviocytes and chondrocytes & suppress production of IL-1 and TNF-alpha all of which contribute to cartilage breakdown

22
Q

triamcinolone

Study These Flashcards
A

labeled for use in horses
(musculoskeletal/joint inj)

23
Q

isoflupredone

Study These Flashcards
A

labeled for use in swine & cows
(musculoskeletal/joint inj)

24
Q

flumethasone

Study These Flashcards
A

labeled for use in horses & dogs
(musculoskeletal/joint inj)

25
methylprednisolone & betamethasone
ELU (musculoskeletal/joint inj)
26
adverse effects of... - triamcinolone - isoflupredone - flumethasone - methylprednisolone and betamethasone
* muscle atrophy (increases circling amino acids) * osteoporosis (increases Ca excretion annd inhibits osteoblast function) * inhibits fibrocartilage growth (don't use in growing animals)
27
what are the major reasons to NOT USE glucocorticoids in treatment of integument conditions
* cutaneous food allergies * infectious or parasitic (bacteria/fungal infections, flea allergy dermatitis) *
28
what drug is used for the treatment of IBS
Prednisolone
29
what are the drug options for treatment of bovine ketosis
both: induce gluconeogenesis * **dexamethasone** (abortant) * **isoflupredone** (may cause hypokalemia, less risk for abortion)
30
what are the causes of hyperadrenocorticism (mostly dogs)
* pituitary tumors (85%) * adrenocortical tumors (15%) * iatrogenic (glucocorticoids)
31
effect of glucocorticoids on the cardiovascular system
**vasoconstriction** b/c increased sensitivity to sympathetic stimulation **hypervolemia** due to aldosterone causing retention of Na and H2O Hypervolemia --> increased BP, compensatory decrease in ADH secretion, dilute urine, PU/PD
32
Glucocorticoids antagonize insulin, leading to ?
hyperglycemia; increases gluconeogenesis
33
effects of glucocorticoids on circulating fatty acids
increases circulating FAs, leads to fat redistribution that contributes to thin skin and potbelly
34
why can hyperadrenocorticism cause gastric ulcers and colonic perforation
decreased PLA2 causes a reduction in prostagladin production, prostaglandin helps maintian mucous integrity
35
under what cicumstances can hyperadrenocorticism lead to adrenal atrophy
only with iatrogenic hyperadrenocorticism
36
Cosyntropin
ACTH stimulation test (peaks effects occur at 30 min for hoses, 60 min for dogs) hyperadrenocorticism would cause an above average spike in serum cortisol levels post Cosyntropin admin
37
how can iatrogenic hyperadrenocorticism be confirmed
no response to the cosyntropin ACTH stimulation test confirms adrenal insufficiency and iatrogenic hyperadrenocorticism
38
what is the low dose dexamethasone suppression test
**Dexamethasone suppresses ACTH and CRH si it should reduce circulating cortisol ** measured at 4 and 8hrs post admin if cortisol levels are still high at hour 8 --> hyperadrenocorticism
39
what is the drug of choice for small animal **hyper**adrenocorticism
Trilostane
40
what is the MOA of trilostane
**competitive inhibitor of 3β-hydroxysteroid dehydrogenase** reduces but doesn't eliminate the synthesis of corticosteroids
41
what are the adverse effects of Trilostane
* hypocortisolemia - lethargy, anorexia * hyponatremia * GI upset (D/V+) * adrenal gland necrosis (super rare)
42
drug that destroys the zona reticularis and fasciculata but doesn't reduce mineralcorticoid production
Mitotane
43
Equine cushings disease (PPID) cause
tumor in pars intermedia causes pressure atrophy of dopaminergic neurons in the hypothalamus reduces inhibition of ACTH release = cortisol release
44
treatment for PPID in horses
Pergolide mesylate highly potent dopamine receptor agonist
45
what are the to go home corticosteroids (4 to go home)
* Pred * Methylpred * Triamcinolone * Fludrocortisone
46
Emergency corticosteroids (IV admin)
* Pred * methylpred * dexamethasone
47
what is the strongest mineralcorticoid
**Fludrocortisone**
48
what is the strongest glucocorticoid
**dexamethasone**
49
what mineralcorticoid has the longest duration
Deoxy pivilate (IM) one month!
50
what corticosteroids are glucocorticoids only
* Triamcinolone * Dexamethasone
51
what corticosteroids are mineralcorticoids only
* deoxy pivilate * aldosterone

PHARMACOLOGY I (21 decks)

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